Delinquency

Offenses Against Others

Have you ever…?

If yes, how many times?

• Physically beat up other kids.
• Hurt someone badly enough that they had to go to a doctor.
• Threatened or attacked someone with a knife, gun, or other weapon.
• Been in a gang fight.
• Taken money or other things from someone else by using force or threats.
• Picked a fight with other kids.
• Openly defied a teacher or official at school.
• Openly defied a teacher or leader at church.
• Pushed, shoved, or hit one of your parents.
• Been suspended or expelled from schools.
• Cursed or sworn at one of your parents.

Offenses Against Property

Have you ever…?

If yes, how many times?

• Stolen anything worth between $5 and $50.
• Stolen anything worth less than $5.
• Purposely ruined or damaged someone’s else’s property or possessions.
• Taken something from a store without paying for it.
• Stolen something from someone else’s locker, desk, purse, etc.
• Purposely damaged or destroyed things at school, store, etc.
• Thrown things (rocks, bottles, eggs, garbage, etc.) at cars, people, or buildings.
• Gone on someone’s property when you weren’t supposed to be there.
• Stolen anything worth more than $50.
• Taken a car or other motor vehicle without the owner’s permission.
• Broken into a building, car, house, etc.

Status Offenses

Have you ever…?

If yes, how many times?

• Drank alcoholic beverages (beer, wine, liquor).
• Used marijuana (“grass,” “pot”).
• Been drunk or high on drugs.
• Smoked cigarettes.
• Used other drugs (heroine, LSD, amphetamines, etc.)
• Used “smokeless” or chewing tobacco.
• Been involved in heavy petting.
• Used cocaine (“crack,” “coke”)
• Had sexual intercourse.

Peer Pressure for Delinquent Behavior

Offenses Against Others

Has anyone pressured you to:

If yes, how many times?

• Physically beat up other kids.
• Purposely pick on other kids, make fun of them, or call them names.
• Make obscene phone calls.
• Take money or other things from someone by using force or threats.
• Curse or swear at one of your parents.
• Join in a gang fight.
• Shove or hit one of your parents.

Offenses Against Property

Has anyone pressured you to:

If yes, how many times?

• Take something from the store without paying for it.
• Steal anything worth less than $20.
• Throw things (rocks, bottles, eggs, etc.) at cars, people, or buildings.
• Break into a building, car, house, etc.
• Take a car or other motor vehicle without the owner’s permission.

Status Offenses

Has anyone pressured you to:

If yes, how many times?

• Drink alcoholic beverages (beer, wine, liquor).
• Use marijuana (grass,” “pot”).
• Smoke cigarettes.
• Use “smokeless” or chewing tobacco.
• Use other drugs (heroin, LSD, amphetamines, etc.)
• Be involved in heavy petting.
• Watch sexually explicit or pornographic movies, videos, or television programs.
• Read sexually explicit or pornographic books or magazines.
• Have sexual intercourse.
• Use cocaine (“crack,” “coke”).
• Skip school without a legitimate excuse.
• Run away from home.
• Sell marijuana, cocaine, or other drugs.

Peer Example of Delinquency

Offenses Against Others

How many of your friends have done the following?

1. None 2. Some 3. Most 4. All

• Picked a fight with other kids.
• Taken money or other things from someone by using force or threats.
• Physically beat up other kids.
• Hurt someone badly enough that they had to go to a doctor.
• Openly defied a teacher or leader at school.
• Been in a gang fight.
• Threatened or attacked someone with a knife, gun, or other weapon.
• Purposely picked on other kids, made fun of them, or called them names.
• Cursed or sworn at one of their parents.
• Pushed, shoved, or hit one of their parents.
• Called someone on the telephone to threaten or bother them.
• Openly defied a teacher or leader at church.

Offenses Against Property

How many of your friends have done the following?

1. None 2. Some 3. Most 4. All

• Stolen anything less than $5.
• Purposely ruined or damaged someone else’s property or possessions.
• Stolen anything worth between $5 and $50.
• Taken something from the store without paying for it.
• Purposely damaged or destroyed things at school, store, etc.
• Stolen something from someone else’s locker, desk, purse, etc.
• Thrown things (rocks, bottles, eggs, garbage, etc.) at cars, people, or buildings.
• Gone on someone else’s property when they weren’t supposed to be there.
• Stolen anything worth more than $50.
• Broken into a building, car, house, etc.
• Taken a car or other motor vehicle without the owner’s permission.

Status Offenses

How many of your friends have done the following?

1. None 2. Some 3. Most 4. All

• Drank alcoholic beverages (beer, wine, liquor).
• Been drunk or high on drugs.
• Smoked cigarettes.
• Used marijuana (grass,” “pot”).
• Been involved in heavy petting.
• Have engaged in sexual intercourse.
• Used “smokeless” or chewing tobacco.
• Read sexually explicit or pornographic movies, videos, or television programs.
• Used other drugs (heroine, LSD, amphetamines, etc.)
• Been suspended or expelled from school.
• Used cocaine (“crack,” “coke”).
• Skipped school without a legitimate excuse.
• Created a disturbance by being loud, unruly, or disorderly at school or other public place.
• Cheated on a test.
• Run away from home.

Religiosity

Religious Beliefs

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• The Book of Mormon is the word of God.
• Joseph Smith actually saw God the Father and Jesus Christ.
• Jesus Christ is the divine Son of God.
• The Lord guides the Church today through revelations to Church leaders.
• There is life after death.
• The president of the LDS Church is a prophet of God.
• God lives and is real.
• Satan actually exists.
• The Bible is the word of God.
• God really does answer prayers.

Private Religious Behavior

How often do you do the following activities?

1. Very Often 2. Often 3. Sometimes

4. Rarely 5. Never

• I read the scriptures by myself.
• I pray privately.
• I pay tithing on the money I earn.
• I fast on Fast Sunday.

Public Religious Behavior

How often do you do the following activities?

1. Very Often 2. Often 3. Sometimes

4. Rarely 5. Never

• I attend Sacrament Meeting.
• I attend Priesthood Meting or Young Women’s Meeting on Sunday.
• I attend Sunday School.
• I participate in Church social activities.

Importance of Religion

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• I plan to be active in the Church.
• I plan to marry in the temple.
• I have a strong testimony of the truthfulness of the gospel.
• I am a good example of living the gospel to my friends.
• During the past year, I have really tried to live the standards of the Church.
• My relationship with God is an important part of my life.
• In my life there are more important things than religion.
• I very seldom think about religion.

Spiritual Experiences

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• I have been guided by the Spirit with some of my problems with my life.
• There have been times in my life when I felt the Holy Ghost.
• I know what it feels like to repent and to be forgiven.

Social Acceptance into Congregation

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• I am well liked by members of my ward.
• I seem to fit in very well with the people in my ward.
• I sometimes feel like an outsider in the Church.

Self-Esteem

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• I take a positive attitude about myself.
• All in all, I am inclined to feel like I am a failure.
• I feel like I have a number of good qualities.
• On the whole, I am satisfied with myself.
• At times, think I am no good at all.
• I feel I do not have much to be proud of.
• I wish I could have more respect for myself.
• I feel that I’m a person of worth at least on an equal plane with others.
• I certainly feel useless at times.
• I am able to do things as well as most people.

Risk Taking

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• I like to take changes or do things on a dare.
• I like to test myself every now and then by doing something a little risky.
• I get a real kick out of doing things that are a little dangerous.

Impulsiveness

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

• I am one of those people who blurts out things without thinking.
• I often act on the spur of the moment without stopping to think.
• I am often said to be hotheaded or bad-tempered.

Connection with Mother/Father

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

My Mother (Father) is a person who…

• Cheers me up when I am sad.
• Gives me a lot of care and attention.
• Is able to make me feel better when I am upset.
• Makes me feel better after talking over my worries with her (him).
• Is easy to talk to.
• Believes in showing her (his) love for me.
• Enjoys doing things with me.
• Smiles at me often.
• Makes me feel like the most important person in her (his) life.
• Often praises me.

Mother/Father Regulation

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

My Mother (Father) is a person who…

• Knows what I do with your free time.
• Knows where I go at night.
• Knows how I spend your money.
• Knows where I am most afternoons after school.
• Knows who my friends are.

Psychological Autonomy

How do you feel about the following statements?

1. Strongly Agree 2. Agree 3. Mixed Feelings

4. Disagree 5. Strongly Disagree

My Mother (Father) is a person who does not . . .

• Stop talking to me until I please her (him).
• Avoid looking at me when I have disappointed her (him).
• Always try to change me.
• Say if I really cared about her (him) I would not do things that cause her (him) to worry
• Only keep rules when it suits her (him) best
• Want to control whatever I do
• Act less friendly to me if I do not see things her (his) way
• Want to be able to tell me what to do all the time
• Always tell me how I should behave
• Tell me all the things she (he) has done for me

Family Conflict

How often do you do the following activities?

1. Very Often 2. Often 3. Sometimes

4. Rarely 5. Never

• I see my parents arguing.
• My parents yell and scream at each other when I’m around.
• My parents nag and complain about each other around the house.

Depression

Below is a list of ways you might have felt or behaved during the PAST WEEK. On how many days during the week did you

• a. Feel bothered by things that usually don’t bother you?
• b. Feel that you could not shake off the blues, even with help from family and friends?
• c. Have trouble keeping your mind on what you were doing?
• d. Feel depressed?
• e. Feel that everything you did was an effort?
• f. Feel you could not get going?
• g. Feel fearful?
• h. Sleep restlessly?
• i. Feel lonely?
• j. Feel sad?
• k. Not feel like eating; your appetite was poor?
• l. Talk less than usual?